- Catholic Health Services (Melville, NY)
- …why Catholic Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews ... payors for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as required.… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: The Clinical Manager , Provider Appeals supports appeals team members to plan, direct, evaluate, coordinate, and manage the activities ... associated with the Provider Appeals as it relates to key HAP initiatives and...the provider community to optimize the member experience. Analyze utilization trends to identify opportunities for improvement. Meet with… more
- LA Care Health Plan (Los Angeles, CA)
- Manager , Customer Solution Center Appeals and Grievances Job Category: Management/Executive Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... to support the safety net required to achieve that purpose. Job Summary The Manager , Customer Solution Center Appeals and Grievances is responsible for the… more
- BronxCare Health System (Bronx, NY)
- Overview The Appeals Manager is responsible to assist in the analysis and preparation of response to denial notification letters that arrive in letter and ... to best respond to all hospital denials notification and documentation efforts. The Appeals Manager will provide timely tracking and trending of all denials… more
- Molina Healthcare (GA)
- …Utilization Management, Chief Medical Officer, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training, leadership and mentoring for less ... request authorization. Strongly prefer candidates with a background in appeals and grievances. Excellent computer multi-tasking skills and good productivity… more
- Munson Healthcare (Traverse City, MI)
- …in written and verbal communication skills. ORGANIZATIONAL RELATIONSHIP . Report to the Manager of Utilization Management and works closely with the ... Utilization Management and Appeals team . Interacts independently with all Munson Health...skills 6. Monitors and sorts incoming communication to the Utilization Management and Appeals department, including faxes,… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you...strategy in response to reimbursement denials. + Responsible for appeals and follow up on clinical denials escalated through… more
- UNC Health Care (Chapel Hill, NC)
- …care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management ... needs are met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in… more
- Beth Israel Lahey Health (Burlington, MA)
- …a job, you're making a difference in people's lives.** Manages the Utilization Management (UM) team, maintaining effective and efficient processes for determining ... in the context of other Revenue Cycle functions such as Denials & Appeals , Patient Access, Authorization Management & review, HIM, Coding & Billing. Close… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** Manages the utilization of referral services. Enhances quality of care by assuring compliance with policies, including safety, ... **ESSENTIAL FUNCTIONS:** + Trains staff on standards of practice of Utilization Management and reimbursement methodologies and treatment coding. + Manages policies… more
Recent Searches
- Phlebotomist Patient Access Rep (Louisiana)
- Cake Decorator Part Time (Connecticut)
- Senior Front End Software (Michigan)
- intern economics ww returns (United States)
Recent Jobs
-
Direct Support Professional - Registered Behavior Technician (DSP-RBT)
- YAI (Milford, NY)